Assessment Questions for the CST Exam — Practice Free

The two mandatory identifiers are the patient's Full Name and Date of Birth (DOB). Rationale: These must be verified against the patient's ID band and the medical record. Clinical Pearl: Never use the patient's room number as an identifier, as it is transitional and not unique to the individual. For the CST exam, remember that the patient (if able) should verbally state these while the circulator checks the band. Strategy Tip: NBSTSA often uses room number as a high-frequency distractor. Check the band, the chart, and the surgical consent for consistency.

If a patient refuses site marking, the refusal must be documented in the medical record. However, the site must still be identified and verified by the team. Clinical Pearl: The surgeon is ultimately responsible for the marking, which must be visible after the patient is prepped and draped. Strategy Tip: NBSTSA emphasizes that while the surgeon marks the site, the CST must confirm the mark is present and visible during the Time-Out. If the mark is missing, the procedure must not start until the surgeon marks it.

The Time-Out is performed immediately before the incision is made (or start of procedure). All members of the surgical team (Surgeon, Anesthesia, Circulator, and CST) must be present and cease all other activities. Clinical Pearl: The CST must stop setting up instruments and give full attention. Strategy Tip: The NBSTSA frequently asks about the Universal Protocol. The key is immediately before incision. If the surgeon is not in the room, the Time-Out cannot be completed.

The CST must immediately notify the circulator and surgeon of the discrepancy. The patient cannot be transported to the OR until the conflict is resolved. Clinical Pearl: The consent is the legal document; if it contradicts the schedule, the surgeon must clarify with the patient and potentially obtain a new, correct consent. Strategy Tip: On the CST exam, any discrepancy in identification or consent requires a Stop and Verify approach. Never assume the schedule is correct over the signed consent.

Identification must be verified by comparing the patient's ID band with the medical record and having a parent or legal guardian confirm the patient's identity. Clinical Pearl: In pediatrics, the guardian acts as the verbal verifier. The CST should ensure the ID band is present on the patient (usually the ankle or wrist) and matches the chart exactly. Strategy Tip: For non-verbal or minor patients, the NBSTSA looks for the involvement of the legal guardian as the standard of care.